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Local Government and Public Involvement in Health Bill

My Lords, we debated this matter in part in Committee and during the summer we thought about what the noble Baroness seeks to do. She is a very powerful advocate for this. I shall have to disappoint her, although I hope not entirely. I understand the concerns that she raised. I committed to taking the proposal away. As she said, I addressed the point in my letter to noble Lords of 3 October. I am certainly aware that the regulators are not opposed to involving people in their inspection activity. Indeed, CSCI, as we know, already does so, using experts by experience, and the Healthcare Commission uses lay representation on a number of visits, so the practice is well established. That shows how much value they put on the volunteer with experience and people involved in the front line of the health service. That is extremely important. Both regulators are keen for the new health and social care regulator to involve patients and/or the public, as appropriate, in follow-up inspections carried out for the annual health check and in other site visits associated with service reviews. I am not sure that I accept that experts by experience is the default position with CSCI, as a lot of this comes down to the regulators’ need to use their own judgment. We have spoken to the Healthcare Commission and CSCI and we are not clear that they support routinely involving lay representatives in every visit they undertake, as it is not always appropriate to do so; rather, they seek lay involvement as and when it is appropriate, as I said. In the context of the Bill I understand that they have envisaged locally organised lay involvement, designed to suit the purpose of each inspection, via the new LINks. I believe that this is the best and most practical and proportionate way forward. However, I shall think about whether we can include something on this in guidance. Although I cannot endorse the proposal—it would be difficult to do so on behalf of the regulators without being absolutely certain what they are after—I shall consider whether we can indicate that we are at least partially in favour of it.